Antidepressant use among survivors of childhood, adolescent and young adult cancer: a report of the Childhood, Adolescent and Young Adult Cancer Survivor (CAYACS) Research Program

Abstract

Background: Although survivors of childhood, adolescent, and young adult (AYA) cancer are at risk for late psychological sequelae, it is unclear if they are more likely to be prescription antidepressant users than their peers.

Procedure: All 5-year survivors of childhood or AYA cancer diagnosed before age 25 years in British Columbia from 1970 to 1995 were identified. Those with complete follow-up in the provincial health insurance registry from 2001 to 2004 were included (n = 2,389). A birth-cohort and gender-matched set of population controls 10 times the size of the survivor group was randomly selected (n = 23,890). All prescriptions filled between 2001 and 2004 were identified through linkage to the provincial prescription drug administrative database. Logistic regression analyses determined the impact of cancer survivorship on the likelihood of ever filling an antidepressant prescription.

Results: After adjusting for sociodemographic factors, survivors of childhood and AYA cancer were more likely to have filled an antidepressant prescription compared to controls (OR 1.21, 95% CI 1.09-1.35). Cancer survivors had an increased likelihood of using all categories of antidepressants, and of using drugs from two or more antidepressant categories, compared to peers (OR 1.31, 95% CI 1.11-1.55 [≥2 antidepressant categories]). Treatment was not a significant predictor of antidepressant use. Female survivors, those in young adulthood and those more than 20 years post-treatment had increased antidepressant use.

Conclusions: Survivors of childhood and AYA cancer are more likely to fill antidepressant prescriptions compared to peer controls. This may indirectly reflect an increased underlying prevalence of mental health conditions among survivors.